Are Indigenous mortality gaps closing: how to tell, and when?

Lags between policy and outcomes mean it is important to have good metrics and the right expectations about timelines

It is well known that the health of Australia’s Aboriginal and Torres Strait Islander people is considerably poorer than that of their non-Indigenous counterparts.1 Strategies, policies, programs and funding over many years have been targeted toward improving the health of Indigenous Australians and closing the gap in health status between Indigenous and non-Indigenous Australians. In this article, we review trends in key mortality rates for both populations and two complementary indices of the gap between them, both of which are essential to understanding progress or otherwise in closing the mortality gaps. Importantly, we also discuss the time required until the impact of policy changes can be assessed.

Measures of “the gap”

An understanding of changes in mortality over time requires: (i) graphing the non-Indigenous and Indigenous rates to see whether they are declining, remaining stable or increasing; (ii) showing trends in the rate difference (obtained by subtracting the non-Indigenous rate from the Indigenous rate) to indicate movement in the absolute size of the difference and the magnitude of improvement required for the gap to close; and (iii) showing trends in the rate ratio (obtained by dividing the Indigenous rate by the non-Indigenous rate)…